Darryl Lewis Fortson

Controlled Substance Registration - Physician

Indiana  01037803B   Active

This Indiana license is held by Darryl Lewis Fortson. The license is currently active. It was granted on 08/28/1989 and expired on 10/31/2015

LICENSE DETAILS

  • License Number: 01037803B
  • Category: CSR-Physician
  • Status: Active
  • Date Granted: 08/28/1989 (almost 35 years ago)
  • Expiry Date: 10/31/2015 (over 8 years ago)

LOCATIONS

A Address

1950 45th Ave. Suite# 100, Munster IN 46321-3917